Among gun owners, culturally tailored suicide prevention messages work best

July 28, 2017

BEND, Ore. - Gun owners are much more receptive to suicide-prevention messages tailored to respect their rights as firearms enthusiasts than they are to messages that use language that aims to be culturally neutral, a study published last week suggests.

The research at Oregon State University-Cascades is significant because more than half of the roughly 40,000 people in the United States who take their own lives every year do so with a gun.

Past research shows that the vast majority of people with "suicidal ideation" - thoughts of killing themselves - will live meaningful, productive lives if they get past the rough patch that caused them to think about suicide.

But only 5 percent of people who attempt suicide via firearm survive; hence the need for messaging that's effective in helping friends and family members hold onto guns while their loved ones are experiencing suicidal ideation.

The researchers conducted interviews in 2015 with 39 adult gun owners from rural communities in central Oregon. The goal was to understand the culture of gun ownership and learn about acceptable, non-threatening methods of improving firearm safety that respect the rights of gun owners while also helping suicidal patients stay safe.

The interviews led to a one-page suicide prevention message that encouraged restricting firearm access and also respected the cultural values and rights of gun owners; the opening, for example, read "People who love guns, love you. For many of us, firearms are an American way of life - a constitutional right and a necessity in order to protect ourselves and our families. And with this right to bear arms comes responsibility. Just as we must refuse to be a victim of violent crime, we must also use common sense."

The culturally tailored message was then used as part of a nationwide survey of more than 800 gun owners to determine the likelihood of it causing owners of firearms to engage in multiple key gun safety behaviors for suicide prevention - such as asking a suicidal person to give away his or her guns temporarily to another trusted individual.

Survey participants were randomly assigned to receive one of four messages: a control message that read only, "Mental health and suicide prevention are important public health issues"; a standard, one-page message explaining that suicide is preventable, what the warning signs are, and how to take action; the culture-specific message that resulted from the interviews with gun owners; and a message that combined the tailored message with the standard message.

"Respondents who received our culturally specific message in conjunction with standard suicide prevention content reported the greatest likelihood of taking steps to restrict access to firearms for those deemed at risk of suicide," said OSU-Cascades anthropologist Elizabeth Marino. "This tendency was enhanced for individuals who were more politically conservative, lived in more rural areas, and supported gun rights to a stronger degree.

"The findings underscore the importance of cultural factors in public health messaging," she said. "Messaging that respects the values of gun owners could hold promise in promoting firearm safety for suicide prevention. It's important to understand what matters most to people and not use language that inadvertently promotes values or judgments that are not meaningful to the group you're trying to reach."

In this case, inadvertent promotion could come via words or sentences that suggested an anti-firearm bias.

The study found the standard one-page public health message was no more effective in moving people's attitudes than the one-sentence control message, which was effectively no message.

"Information by itself isn't changing minds at all," Marino said. "But if the language in the message is sensitive and respects culturally specific values, then people are more open to the information and will maybe change their decisions. In such politically and culturally divisive times, it's especially worth noting that there are in fact joint goals that people with diverse perspectives can talk about and reach consensus on as long as we understand each person's cultural framework."

Marino said one of the findings from the informational interviews was that many gun owners are already intervening when necessary by temporarily limiting access to firearms when someone is suicidal.

"This really speaks toward understanding the coping strategies and resilience in communities to solve problems and find ways to build on those," she said. "We based our message on what people are already doing."

Joining Marino in the study were two OSU-Cascades colleagues, psychologist and corresponding author Christopher Wolsko and public health specialist Susan Keys, as well as Holly Wilcox of Johns Hopkins University. The La Pine Community Health Center and its medical director, Laura Pennavaria, also collaborated on the study.

"That interdisciplinary perspective really helped us pay attention to the cultural framework from which all of these attitudes and actions emerge," Marino said. "There are more deaths by suicide than deaths by car accidents every year in the U.S., and suicide is the No. 1 means of violent death globally. It's a really important, pressing issue nationally and internationally."

Marino notes that often someone will make the decision to take his or her life, and then act on it, inside a five-minute window.

"People believe if someone wants to kill himself or herself, they will just eventually do it, but that's actually not the case," she said. "If we can help them get past the rough patch, chances are great that people will survive. They go on to lead full, meaningful lives."

The University of Rochester's Injury Control Research Center for Suicide and the Oregon Health Authority supported this research.

Findings were published last week in Archives of Suicide Research.

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